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Funding Open Access funding enabled and organized by CAUL and its Member Institutions Murdoch Childrens Research Institute,James Cook University,National University of Singapore Ethics declarations Conflicts of interest The authors declare no competing interests

This suggests that pathology in the pulmonary artery wall, particularly when it affects the intimal layer, may play a key role in determining the loss of vascular response to hypoxia that contributes to V A /Q mismatching